A Caring Advanced Practice Nursing Model (eBook)

Foreword 6
Preface 9
Contents 11
1: Advanced Practice Nursing: A Justified Need 12
1.1 Advanced Practice Nursing as an International Phenomenon 13
1.2 Advanced Practice Nursing Yields Positive Effects 17
1.3 Access to Nursing, Care, and Treatment Must Be Improved 20
1.4 Available Resources Must Be More Effectively Used to Meet the Increased Demand for Healthcare Services 23
1.5 Clinical Career Paths Support the Recruitment of Future Nurses 24
1.6 Advanced Practice Nursing Contributes to the Sustainable Development of Healthcare 24
1.7 Key Messages to Policy-Makers 28
References 28
2: Nurses as Advanced Specialists and Advanced Generalists 34
2.1 Progression from Generalist Nurse to Advanced Practice Nurse 35
2.2 From Nurse Specialists to Nurses with a Master’s Degree: Examples from the Nordic Countries 38
2.3 A Bi-continuum Model of Specialist Versus Generalist Nurses 39
2.4 The Advanced Practice Nurse as a T-Shaped Professional 41
2.5 Nurses’ Clinical Practice on the Generalist, Specialist, and Advanced Levels 42
References 43
3: What Is Advanced Practice Nursing? 46
3.1 The Concept of Advanced Practice Nursing: An International Perspective 47
3.2 Characteristics of the Advanced Practice Nursing Role 50
3.3 Definition of Advanced Practice Nursing: A Conceptual, Caring Model 51
3.4 What Is the Difference Between Nurse Practitioners and Clinical Nurse Specialists? 55
3.5 The Advanced Practice Nurse’s Knowledge Base and Broad Competence 58
3.6 Degree of Autonomy in Clinical Work 58
3.7 The Nurse’s Personal Characteristics 59
3.8 Conclusion 59
References 60
4: The View of Knowledge in Advanced Practice Nursing 63
4.1 The Tree-Dimensional View of Knowledge in Advanced Practice Nursing 65
4.2 The Three-Dimensional View of Knowledge as a Synthesis of Knowledge, Skills, and Wisdom 66
4.3 The Three-Dimensional View of Knowledge as Related to Kim’s Knowledge Domains 68
4.4 Knowledge Synthesis in Advanced Practice Nursing 69
4.5 Nurses’ Advanced Clinical Competence as Knowledge in Action 70
References 72
5: The Caring Advanced Practice Nursing Model 74
5.1 The Caring Advanced Practice Nursing Model 75
5.2 The Nurse-Patient Relationship 76
5.3 Central Theoretical Perspectives 76
5.4 Contextual Factors 78
5.5 “The Foundation for Caritative Caring” for Nursing on the Generalist, Specialist, and Advanced Levels 79
5.6 Advanced Practice Nursing in the Dialectical Tension Between the General and the Specific 80
References 81
6: Theoretical Perspectives on Advanced Practice Nursing 83
6.1 A Historical Perspective 84
6.2 Health 85
6.2.1 The Ontological Model of Health 86
6.2.2 The Dialectic of Health as a Synthesis of Pathogenesis and Salutogenesis 87
6.3 A Person-Centered Health Perspective in Advanced Practice Nursing 88
6.4 A Holistic Approach to Advanced Practice Nursing 90
6.5 Ethos as a Person-Centered Fundamental Ethical Approach 92
6.5.1 Dignity and Respect for the Patient as a Person 92
6.5.2 Caritas as Compassionate Love and Mercy 93
6.5.3 Virtue as a Force 94
6.6 Caring as the Core of Advanced Practice Nursing 95
References 96
7: Core Competency Domains in Advanced Practice Nursing 100
7.1 Competency Domain 1: Direct Clinical Care 102
7.1.1 Clinical Assessment and Knowing the Patient 104
7.1.1.1 Health Assessment, Part 1: Health History 105
Collecting Information for the Patient Health History 106
7.1.1.2 Health Assessment, Part 2: Assessment of Patient’s Current Health Condition and Physical Examination 107
7.1.2 Clinical Decision-Making 109
7.1.3 Nursing Care and Management of Patients’ Health Issues 111
7.1.4 Health Promotion and Disease Prevention in Advanced Practice Nursing 113
7.1.5 Three Perspectives on Health Promotion in Advanced Practice Nursing 115
7.1.5.1 Health Promotion When Health Is Understood as the Absence of Disease 116
7.1.5.2 Health Promotion When Health Is Understood as Well-Being 116
7.1.5.3 Health Promotion When Health Is Understood as a Resource 117
7.2 Competency Domain 2: Ethical Decision-Making 118
7.2.1 Ethical Problems/Issues in Advanced Practice Nursing 119
7.2.2 Elements of Ethical Decision-Making 120
7.2.3 The Importance of Cultural Competence for Ethical Decision-Making 124
7.3 Competency Domain 3: Coaching and Guidance 125
7.3.1 Health Education Concepts Associated with Coaching and Guidance 126
7.3.2 Advanced Practice Nurses as Coaches 127
7.3.3 Coaching as Person-Centered Guidance 128
7.3.4 Coaching Patients During Transitions Between Life Phases 130
7.3.5 Coaching Realized as Motivational Conversations 131
7.3.6 Coaching and Guidance Key Summary Points 132
7.4 Competency Domain 4: Consultation 133
7.4.1 Consultation in Its Various Forms 134
7.4.2 Functions Associated with Consultancy in Advanced Practice Nursing 134
7.5 Competency Domain 5: Collaboration 136
7.5.1 Definition of the Concept of Collaboration 137
7.5.2 The Characteristics of Effective and Good Collaboration 138
7.5.3 Collaboration as a Part of Advanced Practice Nursing 139
7.5.4 Reasons Underlying Lack of Collaboration 140
7.5.5 Strategies for Successful Collaboration 142
7.6 Competency Domain 6: Case Management 143
7.6.1 Case Management as a Concept 143
7.6.2 Advanced Practice Nurses as Case Managers 144
7.6.3 Case Management Models in Advanced Practice Nursing 145
7.7 Competency Domain 7: Research and Development 146
7.7.1 Evidence-Based Practice 147
7.7.2 Evaluation of Advanced Practice Nursing Practice 148
7.7.3 Participation in Research and Development 149
7.8 Competency Domain 8: Leadership 149
7.8.1 Historical Factors That Have Influenced Nurses’ Position in Healthcare 150
7.8.2 Advanced Practice Nurses as Leaders 151
7.8.2.1 Clinical Leadership 152
7.8.2.2 Professional Leadership 153
7.8.2.3 Leadership on the Systems Level 153
7.8.2.4 Health Policy Leadership 153
7.8.3 The Characteristics of Leadership Competency in Advanced Practice Nursing 153
7.8.4 Personal Characteristics for Leaders of Advanced Practice Nursing 155
7.8.5 Barriers to the Development of Leadership on the Advanced Level 156
7.8.6 Strategies for Developing Leadership Characteristics 158
7.8.6.1 Prerequisites for Advanced Practice Nurses’ Leadership 158
7.9 Critical Factors in Advanced Practice Nursing 159
References 160
8: Advanced Practice Nursing in Acute Care 169
8.1 Advanced Practice Nursing in Acute Care: International Experiences 170
8.2 Advanced Practice Nursing Outcomes in Acute Care 172
8.2.1 Care Quality 172
8.2.2 Patient Satisfaction 172
8.2.3 Patient Flow and Wait Times 173
8.2.4 Cost Efficiency 173
8.2.5 Approach 174
8.3 The Adult-Gerontology Acute Care Advanced Practice Nurse 174
8.4 Developing New Advanced Practice Nursing Models in Norwegian Acute Care 176
References 178
9: Advanced Practice Nursing in Primary Care 182
9.1 The Development of Expanding Nursing Roles in Primary Care 184
9.2 Summary of Advanced Practice Nursing Outcomes in Primary Care 187
9.3 Examples of Advanced Practice Nursing Roles in Primary Care 189
9.3.1 Patient Flow and Continuity of Care 189
9.3.2 Holistic Home Rehabilitation 190
9.3.3 Geriatric Mental Health Nursing 191
9.3.4 Person-Centered Care Used to Reduce Restraining Measures 191
9.3.5 Identifying Delirium and Improving Functional Ability 191
9.3.6 Home Healthcare Oncological Nursing 192
9.3.7 Continence Nursing 192
9.4 Advanced Practice Nurses as Compliments to Physicians in Nursing Homes 193
9.4.1 Integrated Nursing Teams 193
9.4.2 Advanced Practice Nursing Clinics 193
References 195
10: The Right to Prescribe Medications as an Advanced Practice Nurse 197
10.1 International Overview 198
10.2 Examples of the Development of Nurses’ Prescriptive Authority in the Nordic Countries 201
10.2.1 Sweden 201
10.2.2 Norway 202
10.2.3 Finland 202
10.3 What Are the Benefits of Nurse Prescribing? 204
10.4 Factors That Inhibit Nurse Prescribing 206
10.5 Conclusion 207
References 208
11: Core Factors for the Sustainable Development of Advanced Practice Nursing 211
11.1 Effects of the Inadequate Planning of New Advanced Practice Nursing Models 213
11.2 Leadership’s Importance for Implementation 214
11.3 The PEPPA Framework and the Development and Evaluation of Advanced Practice Nursing 215
11.4 National Guidelines and Certification Schemes 219
References 220
12: Leading Change When Implementing Advanced Practice Nursing 222
12.1 Advanced Practice Nursing as Management’s Vision 223
12.2 Change as a Phenomenon and Concept 224
12.3 Theoretical Perspectives on Leadership During Change 226
12.4 The Eight Steps of the Change Process 227
12.5 The Three-Dimensional Model of Leading Change in Healthcare 228
12.6 Understanding Change and Resistance to Change 231
12.7 Advanced Practice Nurses as Change Leaders 232
References 234
13: Advanced Practice Nursing Education 237
13.1 An Optimal Balance Between Theoretical and Clinical Studies 238
13.2 International Advanced Practice Nursing Educational Programs 239
13.3 International Standards for Advanced Practice Nursing Educational Programs 241
13.4 Overall Structure of Advanced Practice Nursing Educational Programs 244
13.5 Assessment of the Development of Clinical Competence 245
13.6 Objective Structured Clinical Examination for Assessment of Clinical Competence 247
References 248